title: Growth disturbance following metaphyseal bending fractures of the proximal tibia--an experimental study in the mini pig.
abstract: Based on our clinical experience, we postulate that the unilateral "posttraumatic genu valgum" develops on the grounds of an unreduced primary valgus deformity. This induces a disturbance of the consolidation on the medial aspect of the fracture. Subsequently, a partial medial stimulation of the epiphyseal plate develops resulting in a secondary valgus deformity. We succeeded in proving experimentally this postulate using the Mini Pig as an experimental model. We investigated 33 tibiae of 17 Mini Pigs. With radiological follow-up studies we were able to show that the operatively created primary valgus deformity induces an increased valgus deformity of functional significance. This is a model of the unreduced fracture in men. However, the transection of the pes anserinus and the periost per se did not provoke a significant valgus formation. Based on these experimental results and our clinical findings we postulate the following treatment for the metaphyseal bending fractures of the proximal tibia in men: 1. Accurate, usually conservative, reduction of any primary valgus malposition of the fracture. 2. Retention of the corrected position of the tibia in a plaster cast. 3. Compression of the medial aspect of the fracture to prevent disturbance of consolidation and subsequent development of valgus deformity.
authors.affiliation: Department of Paediatric Traumatology, University Children's Hospital, Basel, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Frey
mesh_terms: D000818:Animals; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D013552:Swine; D013556:Swine, Miniature; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology